Mora PE, Lima GV

Language: Spanish
References: 16
Page: 7-10
PDF size: 52.85 Kb.

ABSTRACT

Purpose. To identify the most frequent non-traumatic ocular diseases found in an emergency room, in order to detect the training needs of the medical staff that works in those areas. Method. Emergency room referrals of non-traumatic ocular diseases were reviewed and grouped according to the involved ocular structure; the most common ocular diseases were identified as well. The results were analyzed by rates and 95% confidence intervals (CI) and compared to those reported internationally. Results. 80 patients (age 1-91, mean 28.7) were evaluated, 40 from each gender. The structure that was most frequently involved was the cornea (51.25, 95% CI 40.3-62.2), followed by the conjunctiva (18.75%, 95% CI 10.2-27.3) and the lid (6.25%, 95% CI 0.9-11.5); the rate of involvement of the remaining structures was 5% or lower. The most common disease was corneal abrasion (20%, 95% CI 11.2-28.7), the distribution of the involved structures did not differ statistically from that reported internationally. Discussion. The most common causes of non-traumatic ocular care at the emergency room were diseases of the cornea and conjunctiva. Most of the remaining ocular diseases dealt with in the emergency literature were less frequent than 5%. It is suggested that ophthalmic training for the medical staff at emergency rooms should focus on mastering the care of corneal and conjunctival diseases, and detection of alarm signs that may suggest other diseases that deserve referral.

REFERENCES

1. Tintinalli JE, Ruiz E, Krome RL. Medicina de Urgencias. 4ª ed., Nueva York: Ed. Interamericana; 1997.

2. Wheal AJ. Cuidados del paciente en Medicina Interna. En: Ewald GA, McKenzie CR. Manual de Terapéutica Médica. 9a edición. Barcelona, España: Masson-Little, Brown, S.A.; 1996, pp. 28-33.

3. Ho MT, Saunders CE. Diagnóstico y tratamiento de urgencias. 2ª edición. México: Manual Moderno; 1991.

4. Pantoja MJP, Cárdenas VF. Manual de Terapéutica Médica y procedimientos de urgencias. 3a. Ed. México: McGraw-Hill Interamericana; 1997.

5. Sánchez TH, Galindo FA, Iglesias CD, et al. Estudio epidemiológico de las urgencias oftalmológicas en un hospital general. Arch Soc Esp Oftalmol 2004; 79: 425-32.

6. Jan S, Khan S, Khan MN, et al. Ocular Emergencies. J Coll Physicians Surg Pak 2004; 14: 333-6.

7. Mulla ZD, Margo CE. Hospitalization for nontraumatic disorders of the eye and ocular adnexa. Arch Ophthalmol 2004; 122: 262-6.

8. Kaimbo WK, Spileers W, Missotten L. Ocular Emergencies in Kinshasa (Democratic Republic of Congo). Bull Soc Belge Ophtalmol 2002; 284: 49-53.

9. Bhopal RS, Parkin DW, Gillie RF, et al. Pattern of ophthalmological accidents and emergencies presenting to hospitals. J Epidemiol Community Healt 1993; 47: 382-7.

10. Girard B, Bourcier F, Agdabede I, et al. Activité et épidémiologie de un centre d’urgence en Ophtalmologie. J Fr Ophtalmol 2002; 25: 701-11.

11. Shields SR. Managing eye disease in primary care. Part 3 when to refer for ophthalmologic care. Post Grad Med 2000; 108: 99-106.

12. Shuttleworth GN. Marsh GW. How effective is undergraduate and postgraduate teaching in ophthalmology? Eye 1997; 11: 744-50.

13. Goroll AH, May LA, Mulley AG. Primary Care Medicine. 4th Ed. Philadelphia: Lippincott Williams & Wilkins; 2005.

14. Kasper DL, Fauci AS, Longo DL, et al. Harrison’s Principles of Internal Medicine. 16 Ed. New York: McGraw-Hill; 2005.

15. Riad SF, Dart JKG, Cooling RJ. Primary care and Ophthalmology in the United Kingdom. Br J Ophthalmol 2003; 87: 493-9.

16. Howell RM. Corneal Abrasion. En: Adler J, Brenner B, Dronen S, et al. Emergency Medicine. E-Medicine 2002.